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Stable coronary artery disease: revascularisation and invasive strategies

Summary Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces... Full description

Journal Title: The Lancet (British edition) 2015, Vol.386 (9994), p.702-713
Main Author: Piccolo, Raffaele, MD
Other Authors: Giustino, Gennaro, MD , Mehran, Roxana, Prof , Windecker, Stephan, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/26334162
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title: Stable coronary artery disease: revascularisation and invasive strategies
format: Article
creator:
  • Piccolo, Raffaele, MD
  • Giustino, Gennaro, MD
  • Mehran, Roxana, Prof
  • Windecker, Stephan, Prof
subjects:
  • Abridged Index Medicus
  • Angina pectoris
  • Cardiac Imaging Techniques - methods
  • Cardiac patients
  • Cardiology
  • Cardiovascular disease
  • Clinical outcomes
  • Coronary artery bypass
  • Coronary Artery Bypass - methods
  • Coronary Artery Disease - diagnosis
  • Coronary Artery Disease - physiopathology
  • Coronary Artery Disease - surgery
  • Coronary heart disease
  • Coronary vessels
  • Drug-Eluting Stents
  • Evidence-Based Medicine
  • Fractional Flow Reserve, Myocardial - physiology
  • Heart attacks
  • Humans
  • Internal Medicine
  • Ischemia
  • Medical treatment
  • Myocardial Revascularization - methods
  • Percutaneous Coronary Intervention - methods
  • Platelet Aggregation Inhibitors - therapeutic use
  • Postoperative Care
  • Stents
  • Surgery
  • Transluminal angioplasty
  • Treatment Outcome
ispartof: The Lancet (British edition), 2015, Vol.386 (9994), p.702-713
description: Summary Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and arterial conduits greatly improve clinical outcome in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PCI is feasible, safe, and effective in many patients with stable coronary artery disease who remain symptomatic despite medical treatment. In patients with multivessel and left main coronary artery disease, the decision between PCI or CABG is guided by the local Heart Team (team of different cardiovascular specialists, including non-invasive and invasive cardiologists, and cardiac surgeons), who carefully judge the possible benefits and risks inherent to PCI and CABG. In specific subsets, such as patients with diabetes and advanced, multivessel coronary artery disease, CABG remains the standard of care in view of improved protection against recurrent ischaemic adverse events.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionSummary Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and arterial conduits greatly improve clinical outcome in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PCI is feasible, safe, and effective in many patients with stable coronary artery disease who remain symptomatic despite medical treatment. In patients with multivessel and left main coronary artery disease, the decision between PCI or CABG is guided by the local Heart Team (team of different cardiovascular specialists, including non-invasive and invasive cardiologists, and cardiac surgeons), who carefully judge the possible benefits and risks inherent to PCI and CABG. In specific subsets, such as patients with diabetes and advanced, multivessel coronary artery disease, CABG remains the standard of care in view of improved protection against recurrent ischaemic adverse events.
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subjectAbridged Index Medicus ; Angina pectoris ; Cardiac Imaging Techniques - methods ; Cardiac patients ; Cardiology ; Cardiovascular disease ; Clinical outcomes ; Coronary artery bypass ; Coronary Artery Bypass - methods ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary Artery Disease - surgery ; Coronary heart disease ; Coronary vessels ; Drug-Eluting Stents ; Evidence-Based Medicine ; Fractional Flow Reserve, Myocardial - physiology ; Heart attacks ; Humans ; Internal Medicine ; Ischemia ; Medical treatment ; Myocardial Revascularization - methods ; Percutaneous Coronary Intervention - methods ; Platelet Aggregation Inhibitors - therapeutic use ; Postoperative Care ; Stents ; Surgery ; Transluminal angioplasty ; Treatment Outcome
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24Platelet Aggregation Inhibitors - therapeutic use
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20Ischemia
21Medical treatment
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23Percutaneous Coronary Intervention - methods
24Platelet Aggregation Inhibitors - therapeutic use
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26Stents
27Surgery
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abstractSummary Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and arterial conduits greatly improve clinical outcome in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PCI is feasible, safe, and effective in many patients with stable coronary artery disease who remain symptomatic despite medical treatment. In patients with multivessel and left main coronary artery disease, the decision between PCI or CABG is guided by the local Heart Team (team of different cardiovascular specialists, including non-invasive and invasive cardiologists, and cardiac surgeons), who carefully judge the possible benefits and risks inherent to PCI and CABG. In specific subsets, such as patients with diabetes and advanced, multivessel coronary artery disease, CABG remains the standard of care in view of improved protection against recurrent ischaemic adverse events.
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pmid26334162
doi10.1016/S0140-6736(15)61220-X